Individual
DEMETRIA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1153 N HIGHWAY 67 ST, FLORISSANT, MO 63031-4701
(314) 243-1398
Mailing address
1153 N HIGHWAY 67 ST, FLORISSANT, MO 63031-4701
(314) 243-1398
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
J208020005
MO
Other
Enumeration date
03/31/2026
Last updated
03/31/2026
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